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Artificially Induced Pneumothorax for Percutaneous Transthoracic Radiofrequency Ablation of Tumors in the Hepatic Dome: Initial Experience¹

From the Departments of Medical Imaging (T.d.B., C.D., M.L., P.B., J.S.D., A.H.) and Medicine (V.B., M.D.), Institut Gustave Roussy, 94805 Villejuif, France. Received June 9, 2004; revision requested August 19; revision received September 14; accepted October 20. Address correspondence to T.d.B. (e-mail: debaere{at}igr.fr).

After institutional review board approval, informed consent was obtained from six patients (four men and two women, aged 47–74 years) with a total of six tumors of the liver dome. These patients were treated by means of radiofrequency (RF) ablation with computed tomographic (CT) guidance and a transthoracic approach. With use of general anesthesia, a right pneumothorax was induced by means of manual injection of air until the route allowing access to the tumor was cleared of all lung parenchyma. Then RF ablation was performed with transthoracic extrapulmonary transdiaphragmatic access. After retrieval of the RF electrode, the pneumothorax was fully aspirated. All procedures were successfully performed without complications. Artificially induced pneumothorax appears useful and safe for CT-guided RF ablation of liver dome tumors, although this experience was minimal, with only six patients treated.

© RSNA, 2005

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